Survey 1 Claimant Consent Form

Calibration II & Predictive Validity Testing of Item Response Theory – Computer Adaptive Testing Tools (IRT-CAT)

OMB: 0925-0704

IC ID: 212657

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Survey 1 Claimant Consent Form
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 6 Claimant Survey 1 Consent Form Attachment 3_Claimant IRB Approved Consent Form.doc Yes Yes Fillable Fileable

Health Health Care Services

 

3,500 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 3,500 0 3,500 0 0 0
Annual IC Time Burden (Hours) 875 0 875 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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